APH Flashcards
Define an APH
Bleeding from the genital tract after the 24th week of pregnancy and before the birth of the baby
Causes of APH
Local eg cervical polyps, cervical erosion, cervical cancer and infection
Placental abruption
Placenta praevia
Define placental abruption
Premature separation of normally situated placenta by blood vessels of uterus shearing off uterine wall and decidua tissue contains thromboplastins which impairs clotting and can cause DIC and bleeding can fall into hidden revealed or a mixture
Mild abruption- small PV loss uterus not tender no contractions physiologically stable CTG reassuring
Moderate abruption- pV loss of 1 litre tender uterus pain physiological compromise non reassuring CTG
Severe abruption- blood loss greater than 2 litres covelaire uterus shock severe pain IUD of fetus
Risk factors for placental abruption (6)
Pre eclampsia Previous trauma Decompression of over distended uterus Smoking Cocaine use Multiparity of 3 or more
Signs and symptoms of abruption (7)
Abdo pain Back ache constant background pain Frequent low amplitude contractions Couvelaire iterus Vaginal bleeding Hypoveamic shock Non reassuring CTG
Define placenta praevia
Where the placenta is partially/fully implanted near the cervical os 4 types
Type 1- placenta way from internal os
Type 2- placenta partially covering os
Type 3- placenta nearly fully covering os
Type 4- placenta fully covering os
Risk factors for placenta praevia
Multiparity Multiple pregnancy High maternal age Previous LSCS doubles risk Smoking
Signs and symptoms of placenta praevia (5)
Non engaging presenting part Malpresentation Loud mat pulse on Doppler Bleeding after intercourse Painless bleeding
Tina comes into day care with a HX of vaginal bleeding for the last couple of hours she is 28/40 what is your management plan?
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You see Gina on day care who has possible placenta abruption what’s your management plan?
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Freya comes into day care with placenta praevia what’s your management plan?
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